Individual
TONIA L RUDDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
107 MEDICAL DR, DOTHAN, AL 36303-6903
(334) 828-7546
(334) 828-7547
Mailing address
107 MEDICAL DR, DOTHAN, AL 36303-6903
(334) 828-7546
(334) 828-7547
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
26056
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051554856
—
AL
05
—
140835009A
—
GA
Enumeration date
09/13/2005
Last updated
01/25/2023
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